肠化方加减联合西药治疗慢性萎缩性胃炎伴肠上皮化生临床研究  

Clinical Study on Modified Changhua Prescription Combined with Western Medicine for Chronic Atrophic Gastritis Complicated with Intestinal Metaplasia

作　　者：刘军[1] 钱赟达 黄永宏 沈灵娜 陈洁[1] 李玲[1] LIU Jun;QIAN Yunda;HUANG Yonghong;SHEN Lingna;CHEN Jie;LI Ling

机构地区：[1]浙江中医药大学附属嘉兴市中医医院脾胃病科,浙江嘉兴314001

出　　处：《新中医》2022年第4期68-71,共4页New Chinese Medicine

基　　金：浙江省医学会临床科研资金项目(2017ZYC-A79)。

摘　　要：目的:观察肠化方加减联合西药治疗慢性萎缩性胃炎(CAG)伴肠上皮化生(IM)的临床疗效。方法:选取126例CAG伴IM患者,按随机数字表法分成对照组和研究组各63例。对照组给予西药治疗,研究组在对照组基础上加用肠化方加减治疗。2组均治疗3个月。比较2组临床疗效及不良反应;比较2组治疗前后胃黏膜组织指标评分、胃蛋白酶原比值(PGR)、胃泌素(GAS)水平及肿瘤坏死因子-α(TNF-α)水平、白细胞介素-6 (IL-6)水平。结果:研究组总有效率92.06%,高于对照组77.78%(P<0.05)。治疗后,2组黏膜炎症、炎症活动性、腺体萎缩和IM评分均较治疗前降低(P<0.05),研究组黏膜炎症、炎症活动性、腺体萎缩和IM评分均低于对照组(P<0.05)。治疗后,2组PGR均较治疗前升高(P<0.05),GAS、TNF-α、IL-6水平均较治疗前降低(P<0.05);研究组PGR高于对照组(P<0.05),GAS、TNF-α、IL-6水平均低于对照组(P<0.05)。治疗期间2组均未出现明显不良反应。结论:肠化方加减联合西药治疗能有效缓解CAG伴IM患者的临床症状,改善胃黏膜病理形态,降低炎症因子水平,安全性高。Objective:To observe the clinical effect of the therapy of modified Changhua prescription combined with western medicine on chronic atrophic gastritis(CAG) complicated with intestinal metaplasia(IM).Methods:A total of 126 CAG patients complicated with IM were selected and divided into the control group and the study group according to the random number table method,with 63 cases in each group.The control group was treated with western medicine,and the study group was additionally treated with modified Changhua prescription based on the treatment of the control group.Both groups were treated for three months.The clinical effects and adverse reactions in the two groups were compared;before and after treatment,the scores of gastric mucosa indexes,pepsinogen ratio(PGR) and levels of gastrin(GAS),tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the two groups were compared.Results:The total effective rate was 92.06% in the study group,higher than that of 77.78% in the control group(P<0.05).After treatment,the scores of mucosa inflammation,inflammatory activity,glandular atrophy and IM in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the study group were lower than those in the control group(P<0.05).After treatment,the PGR values in both groups were increased when compared with those before treatment(P<0.05),and the levels of GAS,TNF-α and IL-6 were decreased(P<0.05);the PGR value in the study group was higher than that in the control group(P<0.05),and the levels of GAS,TNF-α and IL-6 were lower(P<0.05).During treatment,no obvious adverse reactions were found in both groups.Conclusion:The therapy of modified Changhua prescription combined with western medicine can effectively alleviate the clinical symptoms of CAG complicated with IM patients,improve the pathology of gastric mucosa,and reduce the levels of inflammatory factors,with high safety.

关 键 词：慢性萎缩性胃炎 肠上皮化生 肠化方 胃黏膜病理组织学 胃蛋白酶原比值 胃泌素 炎症因子 

分 类 号：R573.32[医药卫生—消化系统] R574[医药卫生—内科学]